- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $37.15 / $169.82
| Facility | | $8.32 | $37.15 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $11.75
| Professional | | $6.03 | $7.59 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $5.13
| Professional | | $5.13 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $16.98
| Facility | | $8.91 | $12.59 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.59 / $8.32
| Professional | | $6.31 | $7.59 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $18.62 / $30.20
| Facility | | $8.71 | $18.62 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.91 / $13.18
| Professional | | $5.25 | $8.91 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.41 / $64.57
| Professional | | $5.37 | $7.41 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $16.60
| Facility | | $8.32 | $8.32 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.33 / $12.59
| Professional | | $8.32 | $9.33 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.79 / $22.91
| Facility | | $8.32 | $14.79 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $10.00
| Professional | | $7.59 | $7.59 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.59 / $22.39
| Facility | | $9.77 | $12.59 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.59 / $8.32
| Professional | | $6.31 | $7.59 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.00 / $10.00
| Facility | | $7.59 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.90 / $11.48
| Professional | | $3.55 | $4.90 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.37 / $15.14
| Professional | | $3.80 | $4.37 | $15.14 |